Insurance & Billing

Insurance

Linthicum Pediatrics has contracted and participates with the insurance companies listed below. If you do not see your insurance plan below, do not hesitate to call the office and your insurance company for verification of particpation with your plan.

Please have your insurance card and your Drivers License or a Picture Identification Card with you at the time of your office visit. If we file your claim, you are responsible for your co-pay at the time of visit. If we are not a provider for your insurance, if you are not insured or we do not file with your insurance company, you will be responsible for the entire charge at the time of service. It is your responsibility to present and/or disclose all insurance plans that your child(ren) has for all dates of services at Linthicum Pediatrics.

Please note that with all HMO, MCO and POS insurance plans, your child's physician at Linthicum Pediatrics or the practice name Linthicum Pediatrics must be listed as the PCP (Primary Care Physician) on the card to receive services for the date of service in which the card was presented. If you come in for a visit and the PCP has not been changed or is incorrect, you will have to contact the insurance company in the office prior to the visit to correct the PCP. Your appointment time may be prioritized to accomodate other patients in the office and you will be seen at the next available appointment time.

Insurance Plans that we currently accept:

Medical Assistance

• Wellpoint (formerly Amerigroup)
• Aetna Better Health MCO
• JAI Medical Systems
• Maryland Physicians Care
• MD Medical Assistance
• Priority Partners
• Carefirst Community Health Plan of Maryland (formerly University of Maryland Health Partners)
• United Healthcare Community Plan

Please note that with all Medical Assistance Products, your child's physician at Linthicum Pediatrics must be listed as the PCP (Primary Care Physician) on the card to receive services. If you come in for a visit and the PCP has not been changed or is incorrect, you will have to contact the insurance company, in the office prior to the visit to correct the policy. Your appointment time may be prioritized to accomodate other patients in the office and you will be seen at the next available appointment time.

Patient Balances

If you have any questions regarding a statement that you have received in the mail from Linthicum Pediatrics or an Explanation of Benefits from your insurance carrier, what are your next steps:

1. Please contact your insurance carrier and review your Explanation of Benefits with your insurance carrier first.
2. If you have additional billing questions once you have spoken to your insurance carrier, you may contact us with billing questions via the Patient Portal. If you do not have access to the internet you may call 667-888-7337 and request to put a message into our system. Our biller will do the corresponding research so that they can effectively and efficiently get your questions answered in a reasonable timeframe and return your call.

Any services that are determined by your insurance company to be family responsibility (additional co-pays, co-insurance, deductible, etc.) or services considered not covered by your insurance company will be considered a patient balance.

Any balances on a patients account will result in a monthly statement mailed to the guarantor detailing unpaid charges. If you are unclear of any charges incurred, please contact your insurance company for clarification of benefits.

Please note that our P.O. Box has changed. If you have automated bill payments to pay on your account, please be sure to change the address to Linthicum Pediatrics, LLC, PO Box 32348, Belfast, ME 04915-0210. Please note when writing a check, in the MEMO please write in the Account Number or Patient Name and the Date of Service.

Please note that there is an additional charge for services provided outside of our regularly scheduled appointments. These include requests for visits after 5:00pm, Emergency Walk-In Visits that disrupt the regularly scheduled business day, Federal Holidays and Saturday Office Visits. This charge will be billed to your insurance company however this may become your responsibility if the insurance company does not cover this charge.

Self-Pay/Uninsured Patients Policy

For any patient without current active insurance, non-participating insurance plan or a lapse in coverage, we are happy to see your child, please see below for additional details.

Insurance Lapse and Non-Participation

We will provide you with a detailed billing summary for submission to your insurance company if non-participation or lapse in coverage has deemed your child/ren a self-pay patient on the date of service.

No Insurance Coverage

For any patients determined to have no medical insurance coverage, those patients are deemed to be Self Pay patients. All self pay patients will be placed on a discounted sliding fee schedule. In order for the patient to receive the discounted sliding fee schedule rates, payment for services must be paid in full at time of service. If you have a question about the discounted sliding fee schedule, you may contact the office.

Laboratory Testing/Billing

Tests that are performed in our office are billed to the patient's insurance company by the office staff.

All laboratory tests that are retrieved in the office but are sent to an outside laboratory will be accompanied with the patient's insurance information for billing by the laboratory.

All laboratory tests that are requested by your provider and are performed at an outside laboratory are billed directly by the laboratory to your insurance.

Separated/Divorced Families

For families that are separated or divorced and need care for their child/ren, the parent bringing the child to the office is authorizing treatment therefore this is who is responsible for payment on the date of service.

When the child/ren has a contracted insurance plan, the co-pay is due at the time services are rendered. Also, all charges deemed parent responsibility by the contracted insurance plan are due to Linthicum Pediatrics by the parent presenting the child for the date of service and authorizing treatment.

If there is a divorce decree requiring the other parent to pay a portion or all of the treatment costs incurred, it is the authorizing parent's responsibility to collect from the other parent. Arundel Pediatrics will not make special provisions or act as a mediator in collection of payment.

A copy of the claim can be given to the authorizing parent at each visit upon request.

Non-compliance with this policy may result in termination of care.